Does tobacco use affect nearly every organ in the body?

          Yes, smoking as well as the use of other tobacco products which include cigars and smokeless tobacco products can cause or worsen numerous health conditions. These illnesses can also be worsened by secondhand smoke (environmental exposure).

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Is the death associated with smoking preventable?

          Yes, with numerous treatment resources including nicotine replacement therapy, medications, counseling, and more, you can reduce the leading cause of preventable death in the United States. New Jersey is fortunate to offer face-to-face treatment at New Jersey Quit Centers throughout the state and provide telephone cessation support through the NJ Quitline.

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How do E-cigarettes affect my risk for developing disease?

          At this point, the potential health consequences associated with e-cigarettes are not fully known. However, these products may contain nicotine and other toxins which are not considered safe. There have certainly been recent, well-publicized reports of e-cigarettes and vaping devices causing multiple illnesses, including lung disease.

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Could I reduce my risk and quit smoking by using smokeless tobacco instead?

          Smokeless tobacco products are addictive and contain carcinogens associated with developing oral cancer and are not a safe alternative to quitting smoking altogether. The best way to reduce your risk is to stop using all tobacco products.

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What is nicotine?

          Nicotine is the addictive substance found in most tobacco and cigarette products (e-cigarettes included). It enters the bloodstream and reaches the brain very rapidly, which causes the release of a chemical in the brain called dopamine. The release of dopamine provides the pleasurable and addictive effects associated with tobacco use.

 

 

What is menthol?

          Menthol is a flavoring that a variety of tobacco companies have utilized to make cigarettes more appealing to consumers. There are some indications that using menthol-flavored tobacco products may make it harder to quit and could cause additional health concerns.

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Why should I quit smoking?

          Quitting cigarettes can be your own personal journey. Here are some common reasons people have used to motivate themselves to quit:

• Health

  • The surgeon general states that the single most important step a smoker can take to improve both the length and quality of their life, is to quit smoking. Even those who quit smoking later in life will have numerous health benefits.

• Finances

  • Smoking cigarettes can be expensive, when one pack can cost upwards of $10. The average cost of smoking one pack a day per year in the United States is nearly $2,000.

• Friends and Family

  • Cigarettes are not only harmful for you but those around you as well. Secondhand smoke is especially dangerous to the elderly and children and can lead to sickness in both. Studies show that children who live with or around smokers, have higher rates of ear infection, and chest colds. While babies born to mothers who smoke have an increased risk of SIDS (Sudden Infant Death Syndrome) and low birth weight.

• Quality of Life

  • Because smoking can reduce your sense of taste, food will taste better if a smoker can successfully quit

  • In addition to taste, your sense of smell will improve after quitting so you can enjoy fresh air again

  • You will also be able to avoid disruptions while at work, airplane, public spaces, and watching movies with your loved ones after quitting

  • Smoker’s cough will disappear within a few weeks of quitting
     

 

 

When will I start to notice these benefits after I quit smoking?

• 20 minutes after quitting: your heart rate returns to normal

• 12-24 hours after quitting: the carbon monoxide level in your blood returns to normal, and your risk of a major heart attack is significantly reduced.

• 2 weeks to 3 months after quitting: coughing and shortness of breath associated with smoking returns to normal

• 1 year after quitting: Risk of coronary artery disease is half that of a smoker

• 5 to 15 years after quitting: Your risk of having a stroke, oral cancer, throat cancer, and esophageal cancer is reduced to that of a nonsmoker’s

• 10 years after quitting: Your risk of dying from lung cancer is the same as that of a nonsmoker, risk of bladder cancer is half that of a smoker, and risk of cervical and breast cancer decreases.

• 15 years after quitting: Your risk of coronary artery disease is the same as that of a nonsmoker.

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If I cut back on my cigarette amount, my risk must decrease, correct?

• Any amount of cigarette smoking can not only expose you to the 7000 known toxins and associated carcinogens which can cause numerous diseases and cancer, but also reduce your sense of taste and smell, as well as reduce your daily energy levels. A person can compensate for smoking fewer cigarettes by unconsciously inhaling more deeply or smoking more of each cigarette. Therefore, reducing the number of cigarettes smoked per day is not a guarantee that someone is reducing their risk of harm.
  
  
   

Do I have to try and quit smoking on my own?

• Since nicotine is one of the more addictive chemicals in our society, quitting smoking is very difficult.  People who make a quit attempt on their own, with no aids, are less than 5% likely to be successful long-term.  The good news is that you do not have to do it alone.  The most effective way to quit smoking is to use a comprehensive approach that includes medications (NRT, varenicline, bupropion) combined with behavioral counseling (either individually or in groups) along with support and follow-up.  New Jersey offers many ways to help you stop smoking including one of its nearest NJ Quit Centers and the availability of the NJ Quitline, telephone service.  Quitting is hard, but New Jersey can help.
   

 

 

I have tried to quit numerous times, but I keep failing. If I try again, how do I know that I won’t fail again?

• Smoking is very addictive due to nicotine. The daily exposure to toxins found in tobacco smoke increases one’s chance of developing disease. Although almost 90% of all smokers try quitting smoking “cold turkey”, only less than 5% quit successfully. Thus, it may take someone several attempts to fully stop. However, studies show that smokers can significantly improve their quit attempts by enrolling in programs which offer access to tobacco treatment specialists who provide nicotine replacement therapy (patch, lozenge, inhaler, gum, and nasal spray), medications, and individual/group counseling which help reduce your risk of relapse. Research shows that a combination of treatment tools may be more effective in helping you maintain abstinence longer.
   

 

 

What can my doctor prescribe that will help improve my chances of quitting smoking?

• There are currently seven FDA (Federal Drug Administration) approved medications which can help reduce your cravings for tobacco which include 5 FDA approved nicotine replacement therapies (patch, lozenge, inhaler, gum, and nasal spray), as well as medications such as Chantix (Varenicline) or Zyban (Bupropion). The most important thing to consider when using medications to quit smoking is to follow the directions provided by your physician closely, which means making sure you take your medications for the appropriate duration. Many individuals stop taking these medications to soon, and thus do not get the full benefit.

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Can I use e-cigarettes to quit smoking regular cigarettes?

• At this time, the FDA has not found e-cigarettes to be safe or effective as a cessation aid. The 2018 National Academies of Science report indicates that e-cigarettes were not supported as a method to help people quit smoking, and instead promotes the usage of the 7 FDA approved medications as a safer and more effective alternative.

My friend told me I can gain weight after I quit, is this true?

• Some individuals have gained weight after quitting; however, this can be managed through an appropriate diet and exercise regimen. In addition, the use of NRT or bupropion can reduce the amount of weight gain associated with quitting smoking while people continue to use these medications. The long-term benefits associated with smoking will help you remain healthier and increase your life’s longevity which would allow you to lose the weight later.

My spouse/partner smokes and it is harder for me to quit, what should I do?

• At times it is helpful to consider a common goal, and find ways to quit together, which has shown to improve rates of smoking cessation. It is important to remind your friends and family of your intentions to quit smoking and the steps you are taking to alter your lifestyle. Thus, it may be useful to leave the house and go for a walk while one smokers, or exercise together to substitute the downtime someone would use to go out for a cigarette.

What can I do instead of smoking a cigarette, which I do often out of boredom?

• It is important to identify your triggers and address them appropriately. The urge to smoke often will disappear between three to five minutes. To distract yourself from reaching for a cigarette, try to implement a buddy system where you can take a friend or co-worker on a walk outside with you, grab lunch, or attend an event inside of places which are smoke free zones. If you can also identify triggers such as drinking your morning coffee, you can replace this behavior with a separate beverage which will help alter your smoking routine and prevent a relapse after quitting.

I want to quit smoking, but suffer from nicotine withdrawal, is there any methods or treatment that can help?

• To reduce the harm to the health of tobacco users who are unable to stop using nicotine completely can take advantage of nicotine replacement therapy as a substitute for cigarette smoking since they can pose fewer risks to one’s health. The various types of nicotine replacement products include the nicotine: patch, spray, gum, lozenge, and inhaler.

I will be getting knee surgery soon, will smoking before surgery affect me?

• Overall, smokers have lower survival rates after surgery due to lung complications and poor wound healing. Quitting smoking before and after surgery, significantly reduces serious risks for complications and improves lung function, circulation, and overall stamina.

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I quit smoking years ago, but my kids and spouse smoke, am I still at risk?

• Secondhand smoke contains a different mix of the same materials found in tobacco smoke, including toxins which cause cancer. Also, the smoke around your household better known as “Third Hand Smoke”, may deposit onto your clothes, carpet, and kid’s toys, which can also increase toxin exposure. Some common effects of associated with environmental tobacco exposure include low birthweight after pregnancy, asthma exacerbation, heart disease, stroke, cancer, and sudden infant death syndrome.

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After quitting, what are some common symptoms of withdrawal that I may experience?

• After eliminating daily use of tobacco for at least several weeks, an individual may experience

  • Irritability, frustration, or anger

  • Anxiety

  • Difficulty concentrating

  • Increased appetite

  • Restlessness

  • Depressed Mood

  • Insomnia

 

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What signs should I look for to know that I am a highly dependent smoker?

• Common signs supported by evidence indicate higher dependence among smokers are:

  • Smoking within 30 minutes of waking

  • Smoking in areas where it is forbidden

  • Smoking more than 10 cigarettes per day

  • Waking up in the middle of the night to smoke a cigarette

  • Smoking while being ill and bed-ridden

 

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In group behavioral counseling, what can I use to help me quit smoking for good?

• Group and Individual Counseling is generally led by tobacco treatment specialists and serves as both an efficient and effective way  to quit by replicating the social aspects of tobacco use and identifying strategies that have helped others quit or stay abstinent. This provides a unique way to find social support for managing triggers and reinforcing why one should quit.

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What are some techniques I can try along with treatment that can help me practically manage my urges?

• It is most helpful to anticipate obstacles such as common scenarios which trigger your urge for a cigarette which include your morning coffee, driving to work, and during work breaks. Here are some common activities which are utilized in behavioral counseling which improves resistance for smoking

  • Writing down troublesome triggers

  • Eliminating or avoiding cues

  • Identifying safe places

  • Sharing with others your plans to quit

  • Recalling negative consequences of smoking
    
    
    
     

Why should I take advantage of Nicotine Replacement Therapy?

• Studies shows that NRT (Nicotine Replacement Therapy) can be very effective shown by roughly double the success rates among smokers attempting to quit. NRT also helps patients feel comfortable while remaining abstinent by treating nicotine withdrawal directly without being exposed to toxins found in cigarette smoke. NRT primarily works by reducing your cravings and can be used in combination with other non-NRT treatments such as Wellbutrin (bupropion); possibly in combination with Chantix (varenicline).

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When should I not use Nicotine Replacement Therapy?

• If you have certain medical conditions which would warrant a discussion with your physician about usage including previous heart attack, arrhythmia, and pregnancy.

• If you are under the age of 18, you should have parental input.

• If you have allergies to compounds found in NRT products
  
  
  
   

What are the possible uses and side effects associated with NRT?

• Nicotine patch: The over-the-counter nicotine patch is placed directly on your skin to release a low, steady amount of nicotine over time. Possible side effects: Irritation or redness on your skin, dizziness, headache, nausea, racing heartbeat, muscle pain or stiffness, or insomnia
   

• Nicotine gum: You can buy over-the-counter nicotine replacement gum. It comes in 2 mg and 4 mg strengths and you get the nicotine immediately through the mucous membranes in your mouth when you chew it. Possible side effects: Irritation to your mouth or throat, bad aftertaste, problems with existing dental work, nausea, jaw pain, racing heartbeat.
   

• Nicotine lozenges: Like gum, nicotine lozenges are available over the counter. You suck on them, so you get the nicotine slowly. They’re meant to dissolve like hard candies. Possible side effects: Coughing, gas, heartburn, trouble sleeping, nausea, hiccups, racing heartbeat.
   

• Nicotine oral inhaler: The prescription-only inhaler releases nicotine when you attach the cartridge to a mouthpiece and inhale. They’re the nicotine replacement method that’s most like smoking a cigarette. Possible side effects: Coughing, irritation to your mouth or throat, runny nose, nausea. Other side effects that can occur include headache, nervousness, and a racing heartbeat. These are related to the nicotine, not the inhaler itself.
   

• Nicotine nasal spray: This prescription-only nasal spray lets you squirt a quick burst of nicotine into your bloodstream directly through your nose. Possible side effects: Irritation to your nose or throat, coughing, watery eyes, sneezing. These side effects usually get better after 1-2 weeks of treatment. Other side effects that can occur include headache, nervousness, and a racing heartbeat. These are related to the nicotine, not the spray itself.

 

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How effective is Bupropion in helping smokers quit, and what are common side-effects?

• Wellbutrin (Zyban/Bupropion) reduces cravings and withdrawal and can lessen weight gain associated with quitting tobacco. In past clinical trials, Wellbutrin has shown effectiveness in abstinence rates. Wellbutrin is not recommended for use if you have a history of seizures, eating disorders, and electrolyte abnormalities.

• The most common side-effect is Insomnia, while other symptoms include dry mouth, headaches, and rashes.

How effective is Chantix (varenicline) in helping smokers quit, and what are common side-effects?

• Chantix can help smokers quit by also reducing cravings and withdrawal symptoms by releasing lower amounts of dopamine into the brain than cigarette smoke and blocking nicotine from attaching to neuroreceptors which prevents pleasurable feeling associated with smoking a cigarette.

• Common side-effects associated with Chantix use are nausea, insomnia, abnormal dreams, and constipation

Are there alternative therapies such as acupuncture, internet-based counseling, apps, hypnosis, and herbs that I should consider using to help me quit smoking?

• Currently, there is minimal evidence and poorly designed studies which show the utility in using therapies such as herbs, hypnosis, acupuncture, laser, or electrostimulation as effective smoking cessation tools.

• Mobile-based smoking cessation apps and internet-based interventions show beneficial impact in smoking cessation interventions, but there is no evidence that these treatments are more effective than other active smoking treatments such as NRT, Chantix/Bupropion, and Individual/Group Counseling.
  
  
  
   

What points should I take away regarding tobacco treatment and medications?

• There is NO magic pill. NRT, Bupropion, and Chantix, are all FDA approved medications which can reduce cravings/withdrawal and improve your chances at quitting. You can receive more information about these medications through either the NJ Quitline or at any one of the NJ Quit Centers. Evidence shows that combining multiple NRT or Bupropion/Chantix with counseling have higher advantages.